What are the symptoms of femoral head necrosis in children?

Femoral head necrosis in children is a chronic disease. Generally speaking, the onset is relatively slow and it may take a period of time before the symptoms are felt. However, the cure is very complicated, which means that the treatment process will be longer and more difficult to cure. Femoral head necrosis in children is a disease originating from the joints, which causes changes in the bones and can cause pain in children. The more intense the activity, the greater the pain.

Children's femoral head necrosis has a slow onset and a long course of illness, with intermittent claudication and knee and hip pain. The pain often radiates to the inner thigh and knee. The pain may worsen with activity and be relieved after rest. In some cases, the early symptoms are mild or asymptomatic, while in some cases, there is a history of trauma, which may lead to acute onset of symptoms with obvious pain and lameness. When the knee joint hurts, there are tender points when pressing around the hip joint with your hands. Let the child lie flat and lift the affected limb upwards. If the angle cannot reach 45 degrees, there will be pain in the hip joint. Do the "4" experiment: Place the affected limb in a 4 shape on the healthy thigh and press down with the knee. You will feel pain in the hip joint when pressing. In the late stage, the symptoms gradually ease and disappear, the joint movement is normal or there is residual limitation of abduction and internal rotation, the greater trochanter is prominent, and sometimes there is hip flexion or adductor contracture. The thigh and calf often have muscle atrophy, limb shortening and other deformities.

Early lesions are limited to the soft tissue around the hip joint, with enlarged joint capsule shadow, thickened soft tissue, widened joint space, and decalcification of the epiphysis adjacent to the epiphyseal plate due to congestion.

During the ischemic necrosis stage, the density of the ossification center of the femoral head thickens, multiple cystic changes appear in the dense area, the epiphysis becomes ossified, and the nucleus becomes flattened.

During the regeneration and repair period, the femoral head ossifies, the nucleus becomes further flattened, and there are fragmented or translucent areas.

During the healing period, the femoral head may return to normal shape or become flat with subluxation, and the femoral neck may be short and wide, i.e. flat hip. Degenerative arthritis may occur in adults.

Children's femoral head necrosis is divided into early stage, necrosis stage, repair stage and healing stage. The symptoms of each period are different, so the treatment of children's femoral head necrosis must be gradual and cannot be achieved in one step. However, it is still possible to cure femoral head necrosis in children, and parents should give their children confidence.